CERTIFICATE OF LIABILITY INSURANCE (5)
ACORQM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY)
04/01/2005
PRODUCER (813)637-8877 FAX (813)637-8484 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Insurance Office of America, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
4915 w. Cypress Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Suite 100
Tampa, FL 33607 INSURERS AFFORDING COVERAGE NAIC#
INSURED Pyramid Aluminum, Inc INSURER A: AMCOMP Preferred Ins. Co.
530 Commerce Drive South INSURER B:
Suite 4 INSURER C:
Largo, FL 33773 INSURER D:
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
INSR DD'L TYPE OF INSURANCE POLICY NUMBER PR..~Y EFFECTIVE POLICY EXPIRATION LIMITS
GENERAL LIABILITY EACH OCCURRENCE $
f-- DAMAGE TO RENTED
COMMERCIAL GENERAL LIABILITY $
f-- =:J CLAIMS MADE D OCCUR
MED EXP (Anyone person) $
f--
PERSONAL & ADV INJURY $
f-- ---,
GENERAL AGGREGATE $
f--
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $
Ii nPRO- n
POLICY JECT LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
f-- $
ANY AUTO (Ea accident)
f--
ALL OWNED AUTOS BODILY INJURY
f-- (Per person) $
SCHEDULED AUTOS
-
HIRED AUTOS BODILY INJURY
- (Per accident) $
NON-OWNED AUTOS
-
- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
~ ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $
~ OCCUR D CLAIMS MADE AGGREGATE $
$
=l DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND WCV 7049050 04/01/2005 04/01/2006 X I WC STATU- I 10J~-
EMPLOYERS' LIABILITY 100,000
A ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $
r ~r r r EXC~-'---- ~ __.___~ ___,___u ---~-- ,-,--,---'" }-.----,----,-,-----,- --'-,--'-- 'EL-:-TIISEASE'- EAEMPUWEE $'
lUU , UU\.
If yes, describe under 500 , OOC
SPECIAL PROVISIONS below E.L. DISEASE, POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS J LOCATIONS J VEHICLES J EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
~(~5 A~':)R is :,2 ::'
CERTIFIr:ATE HOlDER C.4.Nr:J:1 LATlnN
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
City of Clearwater Housing Division BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
100 Myrtle Ave OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
Clearwater, FL 33756 AUTHORIZED REPRESENTATIVE " --2 /'
Don Leaaett/CHRISR -L. -<< 0 .;y-/
ACORD 25 (2001/08) @ACORD CORPORATION 1988